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Occurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era

Purpose To evaluate the prevalence of multi-carbapenemase-producing Enterobacterales (EB) and the activity of cefiderocol (CFDC), meropenem-vaborbactam (MEV), ceftazidime-avibactam (CZA), and combinations of CZA plus aztreonam (ATM), MEV plus ATM and CFDC plus CZA against them. Methods A collection... Full description

Journal Title: European journal of clinical microbiology & infectious diseases 2022-01-21, Vol.41 (4), p.573-580
Main Author: Bianco, Gabriele
Other Authors: Boattini, Matteo , Comini, Sara , Casale, Roberto , Iannaccone, Marco , Cavallo, Rossana , Costa, Cristina
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0934-9723
Link: https://www.ncbi.nlm.nih.gov/pubmed/35061145
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title: Occurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era
format: Article
creator:
  • Bianco, Gabriele
  • Boattini, Matteo
  • Comini, Sara
  • Casale, Roberto
  • Iannaccone, Marco
  • Cavallo, Rossana
  • Costa, Cristina
subjects:
  • Anti-Bacterial Agents - pharmacology
  • Anti-Bacterial Agents - therapeutic use
  • Antiinfectives and antibacterials
  • Antimicrobial agents
  • Azabicyclo Compounds
  • Aztreonam
  • Aztreonam - pharmacology
  • Bacterial Proteins - genetics
  • Beta lactamases
  • beta-Lactamases - genetics
  • Biomedical and Life Sciences
  • Biomedicine
  • Boronic Acids
  • Carbapenemase
  • Ceftazidime
  • Ceftazidime - pharmacology
  • Cephalosporins
  • Clinical isolates
  • Coronaviruses
  • COVID-19
  • Diffusion
  • Drug Combinations
  • Enterobacterales
  • Enzymes
  • Humans
  • Immunoassay
  • Infections
  • Infectious diseases
  • Internal Medicine
  • Medical Microbiology
  • Meropenem
  • Meropenem - pharmacology
  • Microbial Sensitivity Tests
  • Original Article
  • Oxalic acid
  • Pandemics
  • Phenotypes
  • Public health
  • Synergistic effect
ispartof: European journal of clinical microbiology & infectious diseases, 2022-01-21, Vol.41 (4), p.573-580
description: Purpose To evaluate the prevalence of multi-carbapenemase-producing Enterobacterales (EB) and the activity of cefiderocol (CFDC), meropenem-vaborbactam (MEV), ceftazidime-avibactam (CZA), and combinations of CZA plus aztreonam (ATM), MEV plus ATM and CFDC plus CZA against them. Methods A collection of carbapenemase-producing EB clinical isolates ( n = 1242) was investigated by lateral flow immunoassay NG-Test CARBA-5 and molecular testing. Cefiderocol MICs were determined using broth microdilution Sensititre TM panel. MICs of CZA and MEV were determined by the gradient diffusion method. Antimicrobial synergy testing was performed using gradient diffusion strip crossing. Results KPC were the most frequent carbapenemases (83.2%), followed by VIM (9.2 %), OXA-48-like (4.3 %) and NDM enzymes (4.1%). Multi-carbapenemase producers were found in 10 (0.8%) isolates. Three combinations of two different carbapenemases were observed: KPC+VIM ( n = 4), NDM+OXA-48-like ( n = 4), and VIM+OXA-48-like ( n = 2). CFDC showed potent activity against eight out of ten dual-carbapenemases producers, while resistance or reduced susceptibility was shown towards CZA and MEV. CFDC in combination with CZA showed no synergistic effects and only two additive effects on seven (87.5%) of the CFDC-susceptible strains. Conversely, CZA plus ATM and MEV plus ATM combinations were synergistic against all ATM-resistant strains regardless of dual-carbapenemases phenotype. Conclusions The occurrence of multi-carbapenemase producers is not uncommon in Northern Italy area. MEV in combination with ATM might be considered as a potential therapeutic option, alternative to CZA plus ATM. CFDC susceptibility testing and synergy evaluation of ATM-based combinations should be performed in the lab routine to evaluate the most in vitro active antimicrobial regimen.
language: eng
source:
identifier: ISSN: 0934-9723
fulltext: no_fulltext
issn:
  • 0934-9723
  • 1435-4373
url: Link


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titleOccurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era
creatorBianco, Gabriele ; Boattini, Matteo ; Comini, Sara ; Casale, Roberto ; Iannaccone, Marco ; Cavallo, Rossana ; Costa, Cristina
creatorcontribBianco, Gabriele ; Boattini, Matteo ; Comini, Sara ; Casale, Roberto ; Iannaccone, Marco ; Cavallo, Rossana ; Costa, Cristina
descriptionPurpose To evaluate the prevalence of multi-carbapenemase-producing Enterobacterales (EB) and the activity of cefiderocol (CFDC), meropenem-vaborbactam (MEV), ceftazidime-avibactam (CZA), and combinations of CZA plus aztreonam (ATM), MEV plus ATM and CFDC plus CZA against them. Methods A collection of carbapenemase-producing EB clinical isolates ( n = 1242) was investigated by lateral flow immunoassay NG-Test CARBA-5 and molecular testing. Cefiderocol MICs were determined using broth microdilution Sensititre TM panel. MICs of CZA and MEV were determined by the gradient diffusion method. Antimicrobial synergy testing was performed using gradient diffusion strip crossing. Results KPC were the most frequent carbapenemases (83.2%), followed by VIM (9.2 %), OXA-48-like (4.3 %) and NDM enzymes (4.1%). Multi-carbapenemase producers were found in 10 (0.8%) isolates. Three combinations of two different carbapenemases were observed: KPC+VIM ( n = 4), NDM+OXA-48-like ( n = 4), and VIM+OXA-48-like ( n = 2). CFDC showed potent activity against eight out of ten dual-carbapenemases producers, while resistance or reduced susceptibility was shown towards CZA and MEV. CFDC in combination with CZA showed no synergistic effects and only two additive effects on seven (87.5%) of the CFDC-susceptible strains. Conversely, CZA plus ATM and MEV plus ATM combinations were synergistic against all ATM-resistant strains regardless of dual-carbapenemases phenotype. Conclusions The occurrence of multi-carbapenemase producers is not uncommon in Northern Italy area. MEV in combination with ATM might be considered as a potential therapeutic option, alternative to CZA plus ATM. CFDC susceptibility testing and synergy evaluation of ATM-based combinations should be performed in the lab routine to evaluate the most in vitro active antimicrobial regimen.
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languageeng
publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subjectAnti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antiinfectives and antibacterials ; Antimicrobial agents ; Azabicyclo Compounds ; Aztreonam ; Aztreonam - pharmacology ; Bacterial Proteins - genetics ; Beta lactamases ; beta-Lactamases - genetics ; Biomedical and Life Sciences ; Biomedicine ; Boronic Acids ; Carbapenemase ; Ceftazidime ; Ceftazidime - pharmacology ; Cephalosporins ; Clinical isolates ; Coronaviruses ; COVID-19 ; Diffusion ; Drug Combinations ; Enterobacterales ; Enzymes ; Humans ; Immunoassay ; Infections ; Infectious diseases ; Internal Medicine ; Medical Microbiology ; Meropenem ; Meropenem - pharmacology ; Microbial Sensitivity Tests ; Original Article ; Oxalic acid ; Pandemics ; Phenotypes ; Public health ; Synergistic effect
ispartofEuropean journal of clinical microbiology & infectious diseases, 2022-01-21, Vol.41 (4), p.573-580
rights
0The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022
12022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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3The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022.
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1Boattini, Matteo
2Comini, Sara
3Casale, Roberto
4Iannaccone, Marco
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6Costa, Cristina
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0Occurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era
1European journal of clinical microbiology & infectious diseases
addtitle
0Eur J Clin Microbiol Infect Dis
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descriptionPurpose To evaluate the prevalence of multi-carbapenemase-producing Enterobacterales (EB) and the activity of cefiderocol (CFDC), meropenem-vaborbactam (MEV), ceftazidime-avibactam (CZA), and combinations of CZA plus aztreonam (ATM), MEV plus ATM and CFDC plus CZA against them. Methods A collection of carbapenemase-producing EB clinical isolates ( n = 1242) was investigated by lateral flow immunoassay NG-Test CARBA-5 and molecular testing. Cefiderocol MICs were determined using broth microdilution Sensititre TM panel. MICs of CZA and MEV were determined by the gradient diffusion method. Antimicrobial synergy testing was performed using gradient diffusion strip crossing. Results KPC were the most frequent carbapenemases (83.2%), followed by VIM (9.2 %), OXA-48-like (4.3 %) and NDM enzymes (4.1%). Multi-carbapenemase producers were found in 10 (0.8%) isolates. Three combinations of two different carbapenemases were observed: KPC+VIM ( n = 4), NDM+OXA-48-like ( n = 4), and VIM+OXA-48-like ( n = 2). CFDC showed potent activity against eight out of ten dual-carbapenemases producers, while resistance or reduced susceptibility was shown towards CZA and MEV. CFDC in combination with CZA showed no synergistic effects and only two additive effects on seven (87.5%) of the CFDC-susceptible strains. Conversely, CZA plus ATM and MEV plus ATM combinations were synergistic against all ATM-resistant strains regardless of dual-carbapenemases phenotype. Conclusions The occurrence of multi-carbapenemase producers is not uncommon in Northern Italy area. MEV in combination with ATM might be considered as a potential therapeutic option, alternative to CZA plus ATM. CFDC susceptibility testing and synergy evaluation of ATM-based combinations should be performed in the lab routine to evaluate the most in vitro active antimicrobial regimen.
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1Anti-Bacterial Agents - therapeutic use
2Antiinfectives and antibacterials
3Antimicrobial agents
4Azabicyclo Compounds
5Aztreonam
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8Beta lactamases
9beta-Lactamases - genetics
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12Boronic Acids
13Carbapenemase
14Ceftazidime
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17Clinical isolates
18Coronaviruses
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20Diffusion
21Drug Combinations
22Enterobacterales
23Enzymes
24Humans
25Immunoassay
26Infections
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28Internal Medicine
29Medical Microbiology
30Meropenem
31Meropenem - pharmacology
32Microbial Sensitivity Tests
33Original Article
34Oxalic acid
35Pandemics
36Phenotypes
37Public health
38Synergistic effect
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titleOccurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era
authorBianco, Gabriele ; Boattini, Matteo ; Comini, Sara ; Casale, Roberto ; Iannaccone, Marco ; Cavallo, Rossana ; Costa, Cristina
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6Aztreonam - pharmacology
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18Coronaviruses
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20Diffusion
21Drug Combinations
22Enterobacterales
23Enzymes
24Humans
25Immunoassay
26Infections
27Infectious diseases
28Internal Medicine
29Medical Microbiology
30Meropenem
31Meropenem - pharmacology
32Microbial Sensitivity Tests
33Original Article
34Oxalic acid
35Pandemics
36Phenotypes
37Public health
38Synergistic effect
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2Comini, Sara
3Casale, Roberto
4Iannaccone, Marco
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atitleOccurrence of multi-carbapenemases producers among carbapenemase-producing Enterobacterales and in vitro activity of combinations including cefiderocol, ceftazidime-avibactam, meropenem-vaborbactam, and aztreonam in the COVID-19 era
jtitleEuropean journal of clinical microbiology & infectious diseases
stitleEur J Clin Microbiol Infect Dis
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date2022-01-21
risdate2022
volume41
issue4
spage573
epage580
pages573-580
issn0934-9723
eissn1435-4373
abstractPurpose To evaluate the prevalence of multi-carbapenemase-producing Enterobacterales (EB) and the activity of cefiderocol (CFDC), meropenem-vaborbactam (MEV), ceftazidime-avibactam (CZA), and combinations of CZA plus aztreonam (ATM), MEV plus ATM and CFDC plus CZA against them. Methods A collection of carbapenemase-producing EB clinical isolates ( n = 1242) was investigated by lateral flow immunoassay NG-Test CARBA-5 and molecular testing. Cefiderocol MICs were determined using broth microdilution Sensititre TM panel. MICs of CZA and MEV were determined by the gradient diffusion method. Antimicrobial synergy testing was performed using gradient diffusion strip crossing. Results KPC were the most frequent carbapenemases (83.2%), followed by VIM (9.2 %), OXA-48-like (4.3 %) and NDM enzymes (4.1%). Multi-carbapenemase producers were found in 10 (0.8%) isolates. Three combinations of two different carbapenemases were observed: KPC+VIM ( n = 4), NDM+OXA-48-like ( n = 4), and VIM+OXA-48-like ( n = 2). CFDC showed potent activity against eight out of ten dual-carbapenemases producers, while resistance or reduced susceptibility was shown towards CZA and MEV. CFDC in combination with CZA showed no synergistic effects and only two additive effects on seven (87.5%) of the CFDC-susceptible strains. Conversely, CZA plus ATM and MEV plus ATM combinations were synergistic against all ATM-resistant strains regardless of dual-carbapenemases phenotype. Conclusions The occurrence of multi-carbapenemase producers is not uncommon in Northern Italy area. MEV in combination with ATM might be considered as a potential therapeutic option, alternative to CZA plus ATM. CFDC susceptibility testing and synergy evaluation of ATM-based combinations should be performed in the lab routine to evaluate the most in vitro active antimicrobial regimen.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid35061145
doi10.1007/s10096-022-04408-5
oafree_for_read